Search Results (352)

Background: Mental health needs are rising globally, while workforce shortages constrain access to timely care. Israel launched formal training for Psychiatric–Mental Health Nurse Practitioners (PMHNPs) in 2023 as part of broader efforts to strengthen the public mental health system. This narrative review provides a focused synthesis of international and Israeli literature on PMHNP roles, models of practice, outcomes, and implementation considerations relevant to the Israeli context. Methods: We conducted a narrative, non-systematic literature review of international and Israeli literature on Psychiatric–Mental Health Nurse Practitioners (PMHNPs). Searches were conducted in PubMed/MEDLINE, CINAHL, PsycINFO, and Scopus (January 2000–December 2024), alongside targeted policy and regulatory documents. Eligible sources addressed NP/PMHNP roles, scope of practice, clinical and service outcomes, implementation processes, workforce implications, or policy considerations in high-income health systems. Findings were synthesized thematically. Results: Across the reviewed literature, particularly in primary care and community-based settings, PMHNP/NP-delivered care was generally associated with comparable outcomes on selected quality and safety indicators, alongside improved accessibility, continuity, and high patient satisfaction. Successful implementation depended on regulatory clarity, organizational readiness, interprofessional collaboration, and the development of a clear professional identity. In Israel, the role is emerging within a cautious regulatory framework and may face early barriers related to role ambiguity, variable organizational support, and limited stakeholder awareness. Conclusions: PMHNP implementation may offer an important strategy for strengthening mental health service capacity in Israel. However, the extent of its contribution will depend on regulatory clarity, organizational support, implementation quality, and future empirical evaluation in the Israeli context. Full article

Authentic, situated learning experiences which mirror the collaborative nature of healthcare practice are essential in preparing students for their future professions. Feedback literacy may be thought of as the understanding, capacity, and disposition needed to make sense of information and use it to enhance work or learning strategies. This study explored how feedback literacy can be developed through situated, interprofessional peer-to-peer feedback within a community-based paediatric health screening programme. Using an exploratory Action Research qualitative design, the planning activities stage explored current practice, gathering student insights via interviews, reflections, and a workshop to co-design an Interprofessional Feedback Conversation Guide (IPFCG). The IPFCG was piloted, integrating structured feedback tools and protected time for peer exchange, within the community screening activity. Feedback regarding use of the IPFCG contributed to the gathering data stage, which was followed by the evaluation and reflection stage. Evaluation revealed four key themes: value, engagement, optimising relationships, and structuring conversations. Students valued receiving feedback from peers outside their discipline, actively engaged with the process, emphasised the importance of building rapport, and utilised structured dialogue. These findings highlight how authentic, field-based learning can foster feedback literacy, enhancing the development of professional identity. The interprofessional nature of the program reflects the complexity of modern healthcare and demonstrates how curriculum-integrated models of authentic learning can enhance student engagement and workplace readiness. This study contributes to the evolving conversation about embedding authenticity in higher education and offers a practical model for building collaborative communication within situated learning experiences at scale. Full article

Background: Medication use in paediatric populations is inherently complex and carries a heightened risk of prescribing errors, particularly within primary health-care settings. Despite this concern, evidence describing paediatric prescribing errors in Saudi Arabia remains scarce. Hence, the present study aimed to evaluate the prevalence and patterns of prescribing errors in paediatric primary care and to characterize the pharmacist-led interventions undertaken to resolve these errors. Methods: A prospective, mixed-methods cross-sectional study was conducted over three months at a primary health-care centre. Paediatric outpatient prescriptions were systematically reviewed during routine practice by trained clinical pharmacists. All suspected errors were independently validated and classified for severity by a multidisciplinary expert panel. Descriptive statistics were used to summarise prescribing errors, and associations with patient and prescription characteristics were assessed using chi-square tests. Qualitative data were analysed using a descriptive thematic approach to explore mechanisms of error identification and the nature of corrective pharmacist interventions. Results: A total of 545 paediatric outpatient prescriptions were reviewed, of which 142 prescriptions (26.1%) contained at least one prescribing error. Across these prescriptions, a total of 145 individual prescribing errors were identified. Dose-related errors were the most common (68.3%), followed by inaccuracies in dosing frequency (11.0%) and inappropriate drug selection (9.0%). The occurrence of prescribing errors was significantly associated with patient weight (p = 0.016), the number of medications per prescription (p < 0.001), and the recorded diagnosis (p = 0.018). The majority of errors were intercepted prior to medication dispensing (93.0%), and no cases of patient harm were identified. Qualitative analysis revealed that errors were predominantly detected through cross-checking with authoritative drug references, recalculation of weight-based doses, and application of clinical judgement, and were most often resolved through direct communication with the prescribing clinician. Conclusions: Prescribing errors occur frequently in paediatric outpatient settings; however, most are preventable with appropriate safeguards. Pharmacists play a critical role in identifying and resolving these errors before they result in patient harm. Enhancing paediatric prescribing support systems and strengthening interprofessional collaboration may further advance medication safety within primary health-care services. Full article

Background/Objectives: Despite growing recognition of empathy as a cornerstone of high-quality care, its role within interprofessional collaboration remains underexplored. While the Interprofessional Education Collaborative explicitly references empathy only under the Values and Ethics domain, emerging evidence suggests its potential relevance across all four core competencies. This study aimed to explore the influence of empathy on each of the Interprofessional Education Collaborative core competencies and to highlight its role in the contemporary interprofessional healthcare environment. Methods: A narrative literature review was conducted to identify articles published in English between 2014 and 2025, through searches of PubMed and Scopus. The sub-competency statements of the Interprofessional Education Collaborative framework were used to guide keyword selection and map concepts that empathy may influence. Results: Seventy-two articles were included in this narrative review. According to the literature, evidence suggests that empathy may support humanitarian values and ethical decision making (Values and Ethics), but the mechanisms underlying this remain to be considered. Empathy has also been discussed in relation to therapeutic and team communication (Communication), as well as to processes such as conflict resolution, supportive leadership, team cohesion, and staff well-being (Teams and Teamwork). The evidence regarding the Roles and Responsibilities domain remains relatively limited, preventing definitive conclusions about the potential influence of empathy in this domain. A clear distinction emerges between clinical and interprofessional empathy, with evidence suggesting that both are essential for collaborative practice. Conclusions: Empathy appears to be linked with several domains of interprofessional collaboration and may represent an important relational component in collaborative healthcare practice. However, the influence of empathy may depend on structural and organizational conditions and may vary across different interprofessional healthcare contexts. These findings offer a conceptual bridge between empathy and interprofessional collaboration, providing actionable insights for educators, leaders, and policymakers involved in healthcare training. Full article

The purpose of both precision medicine and precision nursing is to improve patient outcomes. This theoretical article is designed as a conceptual and position paper situated within caring science, with a specific focus on understanding precision nursing across diverse clinical contexts. Rather than presenting empirical findings, the paper synthesizes theoretical perspectives, caring science foundations, and selected scholarly literature. In this position paper, we seek to expand the concept of precision nursing from a caring science perspective with clinical examples, vignettes, from an emergency care context. Precision medicine can be viewed as an effort to truly individualize a treatment and make it as accurate and effective as possible. While the focus on measurable outcomes saves lives, it also carries the risk of narrowing attention to what can be observed and quantified. These visible clinical markers represent only part of what matters in care. To get the full picture of a patient and their treatment, caring must serve as the foundation for precision nursing, as it is caring that ensures that technological advancements remain aligned with individual patient needs. Precision medicine and precision nursing may offer direction, but to provide meaning to the concepts, a grounding in caring science is provided in this study. Full article

Background/Objectives: Research that systematically identifies the components of a psychosocial workplace environment tailored to people with mental illness is limited. This scoping review aimed to map the existing literature and clarify the key concepts of a desirable workplace environment from a psychosocial perspective that enables sustainable employment for people with mental illness. Methods: A scoping review was conducted using the Joanna Briggs Institute methodology. Five databases, including PubMed and Scopus, were searched to extract original English-language, peer-reviewed research articles published between 2003 and 2025 on workplace environments for individuals with mental illness. Two independent reviewers screened the records and selected 16 studies using the population, concept, and context framework. Following data extraction, qualitative inductive analysis was conducted for category development. Results: Five categories and 17 subcategories were identified as psychosocial workplace environments promoting sustained employment: (1) Growth-supportive environments that leverage individual strengths and promote self-actualization; (2) recognition-affirmative environments that respect individual characteristics and are based on fair evaluation and acceptance of diversity; (3) a low-psychological-strain environment featuring predictability and autonomy; (4) a multilayered support network; and (5) a support environment based on interprofessional collaboration and system utilization. Conclusions: Workplace environments supporting the sustained employment of individuals with mental illness appear to involve a multilayered structure integrating self-actualization, predictable and autonomous job design, and comprehensive interprofessional support. The findings provide a preliminary concept map; however, gaps remain in the types and quality of evidence. Future primary research and formal concept analysis are required to validate these components and address existing methodological and contextual gaps. Full article

Background/Objectives: Oral mucositis (OM) is a common complication in onco-hematological patients undergoing chemotherapy and hematopoietic stem cell transplantation, negatively affecting comfort, nutrition, and quality of life. Despite existing assessment tools and recommendations, OM management—particularly non-pharmacological approaches—remains inconsistent, and evidence on nurses’ perspectives and contextual factors is limited. This study explored nurses’ perceptions and experiences regarding non-pharmacological treatments for OM, including educational needs and barriers and facilitators to implementation in clinical practice. Methods: A qualitative descriptive study using inductive content analysis was conducted. Semi-structured interviews were carried out with nurses working in onco-hematological settings in Italy. Data were analysed according to the Elo and Kyngäs framework. Results: Twelve nurses with extensive experience in onco-hematology and transplant care participated in the study. Five main themes emerged: (1) education and training pathways; (2) approaches to mucositis management; (3) nursing competence in OM care; (4) interprofessional collaboration; and (5) governance of practice, including protocols and guidelines. Findings highlighted strong experiential competence, high levels of nursing autonomy in assessment and patient education, and effective interprofessional collaboration, particularly in specialised settings. However, training pathways were predominantly informal, and the availability and use of protocols varied widely across clinical contexts. Conclusions: Non-pharmacological management of OM appears to be sustained primarily by advanced nursing competence and a specialised clinical culture rather than by structured education and standardised governance. Addressing educational gaps and promoting shared protocols may enhance the consistency, quality, and equity of supportive care while ensuring that the findings are clearly reflective of nurses’ experiences. Full article

The rising prevalence of physical comorbidities among patients with mental illness has increased the relevance of physical rehabilitation within psychiatric care. However, specific physical rehabilitation practices in specialized psychiatric hospitals in Japan remain insufficiently documented. This exploratory and descriptive study aimed to characterize the rehabilitation content provided and to categorize patient characteristics and comorbidities in a single specialized psychiatric hospital using an expert-led consensus approach. Clinical data from 150 patients (median age 71.0 years) who received physical rehabilitation were retrospectively analyzed. Patient categorization was conducted through a multidisciplinary consensus-building process involving an expert panel of physical therapists, occupational therapists, psychiatrists, and nurses, each with over 10 years of clinical experience. Using a hierarchical rule set based on International Classification of Diseases, 10th Revision (ICD-10) codes and clinical referral data, five distinct categories were identified: Disuse Syndrome (41%), Neurologic Disorders (20%), Lower Limb Lesions (18%), Parkinson’s Syndrome (15%), and Upper Limb Lesions (6%). Across all categories, rehabilitation interventions focused on foundational motor therapies, such as range of motion (27%) and strength training (23%). Mobility-oriented interventions were selectively provided to patients with high bedridden status based on clinical potential. Overall, practices in this setting primarily targeted disuse syndrome and maintenance of basic motor function and were delivered with input from multiple professional disciplines; such practices may inform future research on structured multidisciplinary rehabilitative approaches, especially for aging psychiatric populations. Full article

Head and neck cancer (HNC) management requires highly coordinated multidisciplinary care. Radiation Therapy Technologists (RTTs) have increasingly expanded their role beyond technical execution, contributing to patient positioning, treatment delivery, monitoring, and supportive care. This narrative review integrates evidence from published literature with structured experiential insights collected through focus group discussions with RTTs and other multidisciplinary team (MDT) members. The resulting conceptual and operational framework highlights RTT contributions across the radiotherapy pathway, including adaptive planning, workflow coordination, and patient-centered interventions, supported by imaging and artificial intelligence (AI) tools for predictive modeling and treatment optimization. By facilitating communication, monitoring anatomical and functional changes, and integrating AI-informed insights, RTTs support timely interventions, reduce treatment interruptions, and enhance treatment safety and precision. Structured training, formal recognition of advanced practice roles, and interprofessional collaboration are key to maximizing the impact of RTTs in HNC care. This review provides a practical roadmap for institutions, professional societies, and research initiatives to support the evolution of RTT roles in complex radiotherapy settings. Full article

Background: Medicine shortages present a critical challenge for health systems worldwide, impacting patient care and health outcomes. This study investigated healthcare professionals’ perceptions of the impact of medicine shortages in public health facilities of the Eastern Cape, South Africa. Methods: A quantitative, cross-sectional design was employed, using a self-administered questionnaire distributed to 394 healthcare professionals (professional nurses, pharmacists, and medical officers). Results: The findings revealed a strong consensus that shortages negatively affect all stakeholders, with 96.7% of respondents agreeing that they increase provider stress and reduce patient trust. A significant majority also reported that shortages lead to delayed treatment (70.6%) and compromised health outcomes (67%). However, perceptions varied significantly by profession. Pharmacists were significantly more likely than nurses and medical officers to perceive that shortages result in increased out-of-pocket costs for patients, treatment errors, and compromised health outcomes. Conclusions: The study concludes that medicine shortages severely impact patient safety, clinical outcomes, and healthcare providers’ well-being in this setting. The pronounced concerns among pharmacists highlight their strained role in managing the crisis and underscore the urgent need for strengthened pharmaceutical supply chain governance, interprofessional collaboration, and targeted policies to mitigate the effects of shortages and protect patients from financial hardship. Full article

Periodontal disease affects 10–50% of the global population and is associated with various systemic conditions, including diabetes, cardiovascular disease and adverse pregnancy outcomes. Emerging evidence highlights diet as a critical, modifiable factor that influences the composition of the oral microbiome and periodontal health. This narrative review explores the molecular mechanisms through which traditional foods modulate the oral microbiome and contribute to oral and systemic health. A comprehensive literature search was conducted in PubMed/MEDLINE, the Cochrane Library, LILACS and Epistemonikos, prioritizing systematic reviews, meta-analyses and randomized controlled trials. The oral microbiome harbors over 700 bacterial species, and dysbiosis, characterized by pathogen enrichment, drives periodontal inflammation. Anti-inflammatory dietary patterns, including the Mediterranean diet, demonstrate protective effects. Omega-3 fatty acids, vitamins C and D, polyphenols and dietary fiber support periodontal health, whereas refined carbohydrates, saturated fats and pro-inflammatory nutrients can exacerbate disease. Probiotics show promise as an adjunctive therapy. However, the translation to clinical guidelines is impeded by methodological challenges, including the limited number of randomized controlled trials with oral endpoints, confounding by hygiene practices, and the lack of standardized multi-omics approaches. Nutritional counselling should be integrated into periodontal care as a modifiable risk factor. Future research priorities include precision nutrition approaches, the validation of salivary biomarkers, and interprofessional collaboration between dental and nutrition professionals. Full article

Background: Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are commonly used to manage acute or moderate-to-severe musculoskeletal pain. Physical Therapists (PTs) are involved in patient management from early on, providing education and advice related to medication use. This study aimed to examine Saudi PTs’ practice patterns and attitudes toward NSAID use and to identify factors associated with key practice outcomes by discussing NSAID use, assessing contraindications, monitoring side effects, and documenting discussions. Methods: A cross-sectional study was conducted between February and June 2025. A total of 371 PTs (52.3% male) from all regions of the country participated. Data were collected using an expert-reviewed and pilot-tested self-administered questionnaire. Descriptive statistics, chi-square tests, and logistic regression were used to analyze the data. Qualitative responses to an open-ended question were analyzed thematically. Results: Over half of PTs (59%) reported frequently discussing NSAID use with patients, particularly over-the-counter topical or oral formulations. Nearly half (48.0%) reported the absence of a formal institutional policy on NSAID discussions, while only 14.6% reported the presence of such policies. Safety practices were inconsistently applied: 46% reported screening for contraindications and 29% monitored potential long-term adverse effects (p < 0.001). Greater involvement in NSAID-related practices was associated with male gender, longer clinical experience, and specialist qualifications. Although 38% supported granting PTs hypothetical prescribing authority, 62% believed they lack adequate knowledge to provide safe and evidence-based medication advice. Conclusions: The study highlights the need for improved pharmacology education, clear national guidelines, and enhanced interprofessional collaboration to promote safe and consistent NSAID use in musculoskeletal care. Full article

Background/Objectives: This study aimed to analyze the perceptions and experiences of health professionals regarding teamwork as an interprofessional competency within the context of Intensive Care Units (ICUs) in a Brazilian public teaching hospital. Methods: This was a qualitative, exploratory study guided by a constructivist–interpretative perspective. The scenario consisted of Intensive Care Units of a public teaching hospital, which is a reference for emergency care, located in Brazil. Sampling was intentional and involved 29 professionals, most of whom, 25 (86.20%), were females, including nurses, nursing technicians, physicians, physiotherapists, and others. In order to collect data, individual semi-structured face-to-face interviews were conducted in 2025, which were audio-recorded and fully transcribed. The criterion for determining the number of participants was theoretical saturation. Data analysis followed the steps of Braun and Clarke’s thematic analysis, conducted inductively, with peer validation and the use of illustrative quotations to ensure credibility. Results: Five main categories emerged: “Understanding teamwork as an interprofessional competency,” “Factors that facilitate interprofessional teamwork,” “Factors that hinder teamwork,” “Tools used in the ICU to develop interprofessional teamwork” and “Individual actions to develop interprofessional teamwork.” The analysis revealed a central tension: although professionals discursively value interprofessional teamwork, its practical implementation is constrained by organizational and hierarchical barriers. Communication was identified as a transversal axis, functioning at times as a facilitator and at other times as a barrier. Conclusions: This study demonstrates that interprofessionality in Brazilian ICUs cannot be sustained solely through individual initiatives, but requires structured institutional strategies, such as formal collaboration protocols, interprofessional education programs, and a revision of hospital organizational culture. Furthermore, although health professionals value interprofessional teamwork, their practice still faces significant barriers. These findings may support managers’ reflection on the need to implement in-service teaching and learning strategies that facilitate interprofessional teamwork, especially those in high-technology units, thus enhancing collaborative practice in health. Full article

Background: Missed nursing care, defined as essential patient care that is omitted or delayed, is a growing source of concern due to its effects on healthcare quality and patient safety. Our aims in this study were twofold: first, we examined the extent and types of missed nursing care, and second, we analyzed the relationship between the care missed by hospital nurses and the staffing and resource adequacy in an academic medical center. Methods: A descriptive cross-sectional study was conducted during the period between November 2022 and July 2023. Data were collected using a self-administered questionnaire that comprised items on socio-demographic and work-related characteristics, items on staffing and resource availability, and items from the ‘MISSCARE’ Survey. Results: The most frequently missed nursing care involved pressure-relieving interventions (Mean = 2.39) and ambulation/mobilization (Mean = 2.27), while medication administration (Mean = 1.60) and glucose monitoring (Mean = 1.56) were missed the least. Labor resource inadequacy (β = 0.315, p < 0.001) and communication and teamwork deficits (β = 0.285, p < 0.001) were positively associated with missed nursing care, whereas staffing and resource adequacy showed an inverse association (β = −0.164, p = 0.006). The model explained 49.8% of the variance in missed nursing care (R² = 0.498). Conclusions: These findings highlight that missed nursing care is a system-level issue primarily associated with staffing and resource constraints rather than individual characteristics. Improving staffing adequacy, resource availability, and interprofessional collaboration may reduce care omissions and enhance patient safety in Saudi Arabian academic medical centers. Full article

Critical thinking is emphasized across ACPE Standards 2025, the Pharmacist Patient Care Process, interprofessional education (IPE) frameworks, and licensure preparation (NAPLEX). Despite this, pharmacy education lacks a practical, theory-grounded framework that operationalizes critical thinking as an observable, assessable reasoning process, particularly in team-based and interprofessional contexts. We developed the AIM (Analyze–Interpret–Manage) framework by integrating the Delphi Consensus definition of critical thinking with the AAC&U VALUE framework, translating foundational theory into a concise, measurable, stage-based model applicable to both individual and collective cognition. AIM was tested using qualitative analysis of transcripts of student team discursive narratives of an assigned IPE scenario. Reasoning behaviors were coded by AIM stage and mapped to the 2016 IPEC Core Competencies and the 2025 NAPLEX competencies to ensure professional relevance and external validity. AIM reliably distinguished discrete stages of critical thinking across teams, revealing consistent patterns in how learners analyzed information, interpreted clinical and ethical significance, and managed decisions collaboratively. Mapping demonstrated strong alignment between AIM stages and IPEC and NAPLEX competencies. Our novel AIM framework offers a scalable approach for defining, teaching, and assessing team-based critical thinking in pharmacy education. By operationalizing critical thinking as a staged reasoning process aligned with professional standards, AIM fills a critical gap between educational theory, interprofessional practice, and licensure preparation. Full article